201701 Terminology Services Track
FHIR Terminology Services
Submitting WG/Project/Implementer Group
FHIR Management Group (FMG)
The FHIR specification includes support for the provision of a terminology service - that is, a service that lets healthcare applications make use of codes and value sets without having to become experts in the fine details of the value set resource, and the underlying code systems. The management and proper use of terminology is fundamental to effective, interoperable data exchange, so this is an important capability to provide and test in the Connectathons.
Proposed Track Lead
Coordinator: Rob Hausam
There is a dedicated FHIR Zulip chat topic on the implementers stream for Terminology Services
- Health Intersections - server
- AEGIS - Touchstone tool and test scripts
- Apelon - Terminology Server (uid/pwd dtsadminuser/dtsadmin): http://fhir.ext.apelon.com:7080/dtsserverws/fhir and Demo Page: http://fhir.ext.apelon.com:7080/DtsOnFhirDemo/logon/Logon.action
- Lantana - FHIR services on Trifolia
- CSIRO - Ontoserver
- NLM - FHIR services on VSAC
- IMO - FHIR services on IMO ProblemIT/ProcedureIT
- Health Language FHIR terminology services
- Canada Health Infoway Terminology Gateway server
- Additional servers and clients
FHIR Terminology Server
For service providers, implement the following operations from http://hl7.org/fhir/terminology-service.html:
- $expand - Value Set Expansion
- $validate-code - Value Set Validation
- $lookup - Concept Lookup
- $translate - Translations (note: there is a typo on the terminology service page for Batch Translation where the text states "validate" not "translate")
- $closure - Maintaining a Closure Table
Support additional capabilities:
- Expansion Profile (experimental) - Expansion Profile FHIR Resource Proposal
- SNOMED CT and LOINC implicit value sets -  
- Support ConceptMap, ValueSet resources and operations ($expand, $validate-code, $lookup) referencing code systems using the new CodeSystem resource (instead of ValueSet.codeSystem) - NEW
Service providers are not required to implement all of this functionality - it's a lot to do. For new implementers, start at the top and work down (generally).
FHIR Terminology Client Consumer
Implement any one or more of:
- Do a value set expansion of one of the value sets in the spec
- Validate a code using the spec against a FHIR value set, a v2 value set, or LOINC or snomed CT
- Look up a display for a code (most appropriate for v2/FHIR conversion)
- Translate a code from one value set to another, based on the existing value set and ConceptMap resources, and/or other additional knowledge available to the server
- Maintain a client-side closure table based on server-side terminological logic
- Experiment with the capabilities of the expansion profile (see description above of the expected capabilities and scenarios)
- References to SNOMED CT and LOINC implicit value sets
- Create (POST, PUT) ValueSet resources referencing in-line and/or external code systems
- Create and perform operations ($expand, $validate-code, $lookup) on ValueSet resources referencing code systems using the new CodeSystem resource (instead of ValueSet.codeSystem) - NEW
At least one server supports all of these operations and capabilities (http://fhir3.healthintersections.com.au). Other servers, including the Apelon server (http://fhir.ext.apelon.com:7080/dtsserverws/fhir, uid/pwd dtsadminuser/dtsadmin) and the others listed above will support several of these operations and capabilities. For a list of functions supported by the Apelon Server, see the demo web app (http://fhir.ext.apelon.com:7080/DtsOnFhirDemo, uid/pwd dtsadminuser/dtsadmin).
Scenarios - See server and client roles as listed above
We are interested in connecting and integrating the terminology services within the other Connectathon tracks. Please let us know of specific integrations that you are participating in or aware of, and post them to the chat and add them here.
The supporting TestScripts and corresponding fixtures will be committed to the FHIR SVN repository.
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